1. Field of the Invention
The present invention is directed to an operating system for the implementation of surgical interventions, and to a method for monitoring and adjusting a laparoscope attached to a robot arm for the visualization of surgical interventions.
2. Description of the Prior Art
Minimally invasive surgery is gaining more and more significance as an alternative to an open surgical intervention. Such interventions are methods wherein operations are implemented with the smallest possible surgical wounds.
In specific fields of this minimally invasive surgery, for example in laparoscopic interventions wherein instruments are introduced into the abdominal region of the patient through small entry openings and are guided and operatively utilized therein by a surgeon, there is the necessity that the instruments be visualized on an external picture screen with a camera (laparoscope) additionally introduced into the abdominal region. For example, the operating technique is currently routinely utilized in the resection of the gallbladder. The surgeon thereby monitors the movement of the instruments only via the picture screen.
Conventionally, the camera is guided during the intervention by an operating (OP) assistant, who assists the surgeon. In addition to the need for additional personnel and the costs that are thereby incurred, the following problems arise due to the manual camera guidance:
The surgeon and the assistant guiding the camera must collaborate in the closest possible proximity and with the utmost degree of consultation during the operation. The assistant must often work predictively since he/she must not only acquire the current position of instruments but must also support the planned instrument guidance of the surgeon.
The camera guidance becomes imprecise and restless given flagging attention and fatigue on the part of the assistant, particularly given operating procedures that last a long time. Further, the instructions that the surgeon gives the camera-guiding OP assistant must be very precise. These instructions can sometimes be misinterpreted.
Moreover, camera guidance generally does not require any highly qualified training, so that many operating assistants are not enthusiastic about doing this type of assistance.
One approach for minimizing the described problems is the camera with instrument mounts. However, the need for follow-up of the camera by an OP assistant during the operation still is not eliminated.
The use of a robot with which the laparoscope is interactively controlled and moved by the surgeon is also known. Given this method, however, the surgeon must additionally concentrate on the control of the camera.
Another approach is disclosed by U.S. Pat. No. 5,820,545, “Method of Tracking a Surgical Instrument with a Mono or Stereo Laparoscope”. The surgical instruments introduced into the body are thereby provided with color-coded markings. These markings are detected by the camera introduced into the body, whereby the camera (laparoscope) is positioned with the assistance of a robot that the surgical instruments guided in the operation are also in the field of view of the camera. When, however, the distance of the surgical instruments from the introduced camera is also to be regulated by the robot, then the use of a stereo camera or of a stereo laparoscope is necessary, i.e. of a camera having two optical devices.
This method, however, has the disadvantage that the instruments must always be in the field of view of the camera for the follow-up of the camera since, otherwise, the camera loses the position of the instruments. Moreover, the follow-up of the camera can be deteriorated due to contamination of the color markings (for example, with blood).
PCT Application 97/29709, “Medical Procedures and Apparatus Using Intrabody Probes”, discloses a method and an apparatus wherein an instrument probe is guided through the body of a patient. The position of this instrument probe relative to another probe situated in the body of the patient is thereby determined, and the instrument probe is guided through the body based on the identified position relative to one another.
Cinquin, P. et al., “Computer Assisted Medical Interventions”, IEEE Engineering in Medicine and Biology, May/June 1995, pages 254 through 263, describes computer-assisted operative interventions making use of position and shape sensors.